Obesity has become a special concern in recent years for the medical profession. A substantial portion of the U.S. population weighs more than the medically indicated ideal body weight and risks an increased incidence of various diseases associated with overweight, such as hypertension, diabetes, and circulatory diseases.
To control obesity, various methods are being used. Appetite depressants, for example, constitute a large portion of the anti-obesity regimen. These drugs work on the central nervous system and while depressing the appetite they also slow down and undesirably effect other functions of the body.
Another approach to achieve weight reduction is the jejunoileal by-pass operation which shortens the intestine available for nutrient absorption. Notwithstanding the operation's beneficial effect initially, it was observed that the body adapts to the shortened intestine and the patient tends to regain the weight lost initially.
Among the other weight reduction methods are the various diets with various degrees of success. The disadvantages of these methods are twofold: a lack of balanced diet resulting in malnutrition, and a requirement of changing the eating habits of individuals which in many cases cannot be maintained over a sufficiently long period of time to attain weight reduction.
There is obviously a need to provide an obesity control regimen which will not adversely effect any of the normal body functions and which will not necessitate a change in the eating habits of individuals.
Broadly defined, the nutritive process includes digestion, absorption and metabolism. This process is the sum total of the physical and chemical activities that take place within the cells and the relationships that exist between the cells and the surrounding environment.
Digestion includes the mechanical and chemical processes whereby food materials are transformed to forms that are suitable in consistency and composition for absorption into the mucosal wall and for utilization by the body. The gastrointestinal tract controls the amounts of certain substances that will be absorbed, prevents the absorption of unwanted molecules, synthesizes enzymes and hormones that are required for the digestive process, and eliminates the wastes remaining after the digestion of the food. The gastrointestinal tract is about 25 to 30 feet long in the adult and includes the mouth, esophagus, stomach, small intestine (duodenum, jejunum and ileum), and large intestine (edum, colon, rectum and anal canal).
The rate at which foods move through the digestive tract depends upon the consistency, composition and amount of food intake. Liquids begin to leave the stomach from 15 minutes after ingestion; carbohydrates leave the stomach faster than do proteins; and fats are even slower to leave than proteins. A large complex meal takes about nine hours to pass from the small intestine into the large intestine. After consumption of a meal, typically 20 to 36 hours are required to eliminate food residues from the body.
The process whereby nutrients move from the intestinal lumen into the blood or lymph circulation is known as absorption and results in a net gain of nutrients to the body. Absorption requires that the nutrients penetrate the cell wall, cross the cell, exit from the cell into the lamina propria, and cross the epithelium of the blood or lymph vessels. Absorption appears to take place primarily from the duodenum and jejunum. (A notable exception is Vitamin B.sub.12, which has a specific absorption site in the lower ileum.) Normally, 98% of the carbohydrate, 5% of the fat and 92% of the protein in the diet is hydrolyzed and the end products are absorbed. The small intestine provides an absorbing surface that is about 600 times as great as its external surface area. This is possible because of the arrangement of the mucosal wall in numerous folds, the four to five million villi that constitute the mucosal lining, and the five hundred to six hundred microvilli that form the "brush border" of each epithelial cell of the villus. The mechanism of absorption is described in more detail, for example, in Normal and Therapeutic Nutrition, 14th Edition by C. H. Robinson, Collier-MacMillan Limited, London, 1972, pp. 1-28.
The control of the absorption process of nutrients through the digestive tract has been investigated in recent years. For example, in the article entitled, "Avian Atherosclerosis: Retardation by Pectin", Science, 14, 1063-1064 (Nov. 20, 1964), birds were fed with food containing pectin that seemed to reduce the utilization of nutrients: the pectin-fed birds excreted three times as much lipid extract and almost twice as much cholesterol as did the control birds.
In the article, "Carrageenan as a Dietary Constituent for the Rat: Faecal Excretion, Nitrogen Absorption, and Growth", Canadian Journal of Biochemistry 43, 479-484, (1965), Hawkins and Yaphe studied the effect of carrageenan, which is a sulfated galactan extractable from certain red seaweeds, in the diet of young rats. The authors observed a slower growth rate in the rats caused by less absorption of dietary nitrogen.
The article "Treatment of Diabetes with Guar Gum", The Lancet, 779-780 (Oct. 15, 1977), describes a study of the effect of guar gum on normal diet of diabetic patients. The article concluded that unabsorbable carbohydrate of the guar type in the diet is useful in the treatment of diabetics.
The article "Effect of Pectin, Gum Arabic and Agar on Cholesterol Absorption, Synthesis, and Turnover in Rats", Journal of Nutrition 108(41), 630-639 (April, 1978), reports on a series of five experiments to determine the effect of pectin, gum arabic, and agar on cholesterol absorption, biosynthesis and turnover in rats. It was found that all three complex carbohydrates decreased cholesterol absorption and that protein had the greatest effect.
The article "Perfluorooctyl Bromide: A Potential Anti-Obesity Compound", Journal of Pharmaceutical Sciences 66(6), 907 (June, 1977), describes the use of perfluorooctyl bromide, a high molecular weight fluorocarbon used as a radiopaque contrast medium, to coat the stomach and intestines for forming a temporary barrier to the absorption of ingested food. There was a slight decrease in weight of the treated group of rats compared to a net increase in weight of the control group at the end of 14 days.